News Scan for Dec 31, 2014

More Listeria cases
Aseptic meningitis in athletes
Measles in South Dakota
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Listeriosis cases linked to caramel apples reach 32 in 11 states

Three more Listeria monocytogenes infections have been identified in an outbreak linked to commercially produced caramel apples, raising the count to 32 cases in 11 states, the Centers for Disease Control and Prevention (CDC) announced in an update today.

Thirty-one of the 32 patients have been hospitalized, and the number of deaths increased by 1, to 6, the CDC said. Listeria contributed to three of the deaths, one death was unrelated to the illness, and the role of the illness in the other two is unclear.

The agency said 10 cases involved pregnant women or newborn babies, up by 1 since the previous update on Dec 22. One fetal loss was reported.

The CDC said 23 of 26 patients who were interviewed reported eating commercial caramel apples before they got sick.

Three companies—Happy Apples, California Snack Foods, and Merb's Candies—have recalled caramel applies after hearing from Bidart Brothers, an apple supplier, that the outbreak may be related to its apples, the CDC noted. Merb's Candies, based in St. Louis, issued the latest recall, on Dec 29.

The CDC is continuing to recommend that consumers refrain from eating any commercially produced, prepackaged caramel apples until more specific guidance can be provided.

Nevada is the latest state affected by the outbreak, reporting one case. Other affected states are Arizona (4 cases), California (2), Minnesota (4), Missouri (5), New Mexico (6), North Carolina (1), Texas (4), Utah (1), Washington (1), and Wisconsin (3).

In Canada, authorities have identified two Listeria monocytogenes infections with the same DNA fingerprint as seen in the US outbreak, according to the CDC.
Dec 31 CDC update
Related Dec 23
CIDRAP News item


Aseptic meningitis in California football players caused by echovirus 30

The first known outbreak of aseptic meningitis associated with echovirus type 30 struck 10 young people in California in late summer, 8 of them members of a football team, according to an article today in Morbidity Mortality Weekly Report (MMWR).

Echovirus types 5, 9, 16, and 24 have previously been associated with aseptic meningitis outbreaks in football teams, the article notes. It states that type 30 accounted for 4.5% of nonpolio enterovirus serotypes in the United States from 2006 to 2008.

All 10 of the individuals infected with echovirus 30 sought care in an emergency department, and 5 were hospitalized. All have recovered. Eight of the case-patients were football players at a Los Angeles County high school; the remaining two were siblings of players.

With 7 of 57 players on one team affected, the attack rate was 12.3%. The relative risk (RR) of illness was higher for linemen than for other players (RR = 5.4 [P = 0.03]).

Likely factors in transmission were thought to be shared water bottles, inadequate washing of the bottles, and poor hand hygiene.
Jan 2, 2015 MMWR article (released Dec 31, 2014)


South Dakota has first measles case in 17 years

South Dakota has identified its first measles case since 1997, the South Dakota Department of Health reported yesterday, as a busy year for measles in the United States neared its end.

The South Dakota case involved an unvaccinated child under age 5 in Davison County, the health department said in a press release.

"South Dakota has good immunization coverage rates but measles is on the rise nationally which means unvaccinated individuals are at risk for exposure when they travel to areas with cases," said State Epidemiologist Lon Kightlinger, PhD, in the release. He said the department is working to identify contacts of the case-patient.

In related news, a measles case has been identified in North Carolina in an unvaccinated resident who recently traveled to India, according to an ABC News Radio report yesterday. The case was reported in Mooresville, the story said.

The North Carolina Department of Health and Human Services' Web site did not show any information about the case today.

For this year, the nation as a whole had 610 measles cases in 24 states through Nov 29, making it the worst year for measles since the disease was officially eliminated in 2000, according to the CDC. By comparison, fewer than 200 cases were reported in 2013.

The CDC said 20 outbreaks accounted for 89% of the cases this year.
Dec 30 South Dakota press release
Dec 30 ABC News Radio
CDC count of measles cases


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